Orthopaedic & Rheumatologic Institute Outcomes

Zoledronic acid infusion for osteoporosis is not recommended for patients with a glomerular filtration rate ≤ 35 mL/min. During 2022, 97.1% of patients had renal function testing with a creatinine level and estimated glomerular filtration rate within 365 days prior to infusion. 93.3%, 96.3%, and 97.6%% of patients undergoing infusion had a creatinine level measured in the preceding 90, 180, and 365 days, respectively before infusion. A chart survey of 20 patients who did not have an estimated glomerular filtration rate in the electronic medical record revealed that 20 had a creatinine done outside Cleveland Clinic, which was documented in the chart prior to zoledronic acid infusion.

Zoledronic acid infusion for osteoporosis may be associated with hypocalcemia after infusion. Patients with hypovitaminosis D are at higher risk for hypocalcemia. Obtaining a vitamin D level at least 6 months prior to infusion is considered standard of care. 83.3%, 90.8%, and 94.2% of patients undergoing infusion had a vitamin D level measured in the preceding 90, 180, and 365 days, respectively before infusion. A chart survey of 20 patients who did not have a vitamin D level in the electronic medical record revealed that 7 had a vitamin D done outside Cleveland Clinic, which was documented in the chart prior to zoledronic acid infusion.